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Radiocapitellar Prosthetic Arthroplasty
Radiocapitellar prosthetic arthroplasty, although uncommonly performed, is an option for the management of isolated radiocapitellar degeneration in patients in whom radial head excision would be inadequate or would leave a too-unstable joint. In patients with an incompetent lateral collateral ligament (LCL) complex or chronic Essex-Lopresti lesions, radiocapitellar prosthetic arthroplasty helps to re-create normal elbow kinematics; however, the arthroplasty must be coupled with LCL repair or reconstruction, or with interosseous membrane reconstruction. Although radial head excision may be sufficient to manage isolated radiocapitellar degenerative arthritis and posttraumatic arthritis of the radiocapitellar joint, radiocapitellar prosthetic arthroplasty may be an alternative treatment option. Additionally, radiocapitellar prosthetic arthroplasty may be performed to manage lateral elbow joint damage in an elbow with an intact LCL complex or torn LCL complex that is reparable or reconstructible, if other management options fail. Malunited or nonunited capitellar fractures (especially those extending into the lateral trochlea) may be managed with radiocapitellar prosthetic arthroplasty if capitellar fracture fragment excision alone is insufficient.